Effect of intracanal diode laser irradiation on fracture resistance of roots restored with CAD/CAM posts

Aim: To evaluate the fracture resistance of roots restored with CAD/CAM-fabricated posts, receiving or not intracanal laser treatment, compared with glass fiber posts under mechanical cycling. Methods: Twenty-seven endodontically treated, single-rooted teeth were divided into 3 groups: group 1 (control), prefabricated glass fiber posts relined with resin composite; group 2, CAD/CAM-fabricated intraradicular posts using Resin Nano Ceramic (RNC) blocks; and group 3, CAD/CAM-fabricated intraradicular posts using RNC blocks in canals irradiated with a 940-nm diode laser (100 mJ, 300-um optic fiber, coronal-apical and apical-coronal helical movements, speed of 2 mm/second, 4 times each canal). After cementation of the coping, cyclic loading was applied at an angle of 135° to the long axis of the root, with a pulse load of 130 N, frequency of 2.2 Hz, and 150,000 pulses on the crown at a point located 2 mm below the incisal edge on the lingual aspect of the specimen. Every 50,000 cycles, the specimens were evaluated for root fracture occurring below or above the simulated bone crest. Results were analyzed by one-way ANOVA followed by Tukey's test (p<0.05). Results: Group 1 was the least resistant, while groups 2 and 3 were the most resistant. Group 1 differed significantly from groups 2 and 3 (p<0.01), but there was no difference between groups 2 and 3 (p<0.01). Conclusion: Treatment of the intracanal surface with diode laser had no influence on fracture resistance of roots restored with CAD/CAM-fabricated posts, but a longer cycling time is required to evaluate the real benefits of diode laser irradiation

Comparative in vitro study of intracanal Enterococcus faecalis reduction using photosensitizers in aPDT

Aim: To compare Enterococcus faecalis reduction after antimicrobial photodynamic therapy (aPDT) used with methylene blue, toluidine blue, tannin, and curcumin as photosensitizers, an adjunct to endodontic chemomechanical preparation (CMP) in root canals of human teeth. Methods: A total of 120 single-rooted teeth were divided into 6 groups (n = 20): G1- CMP and 2.5% sodium hypochlorite (NaOCl); G2- CMP and saline solution; G3- CMP, 2.5% NaOCl, and aPDT with 0.005% methylene blue; G4- CMP, 2.5% NaOCl, and aPDT with 0.005% toluidine blue; G5- CMP, 2.5% NaOCl, and aPDT with 0.005% tannin; and G6- CMP, 2.5% NaOCl, and aPDT with 0.005% curcumin. A portable semiconductor laser was used (660 nm, 100 mW, 1.8 J, 180s) in groups 1, 2, 3, 4, 5, and a blue LED light-curing (420-480 nm, 1200 mV/cm2 ) in G6. For all groups, a 5 min pre-irradiation time was applied. Samples were collected before (initial collection), immediately after (intermediate collection) and 7 days after CMP (final collection) for colony-forming unit (CFU) counting. The Kruskal-Wallis test and analysis of variance (ANOVA) were performed (p < 0.05; 95% confidence interval). Results: In between-group comparisons, there was no significant difference observed in the number of CFUs at the initial (p >< 0.001) and final collections (p >< 0.001) for G2 and G3. In within-group comparisons, the number of CFUs showed a decreasing trend in G4 (p = 0.007) and G5 (p = 0.001). Conclusion: Photosensitizers promoted E. faecalis reduction, with better results for tannin and curcumin. Alternative photosensitizers should be the focus of further studies.>< 0.05; 95% confidence interval). Results: In between-group comparisons, there was no significant difference observed in the number of CFUs at the initial (p < 0.001) and final collections (p >< 0.001) for G2 and G3. In within-group comparisons, the number of CFUs showed a decreasing trend in G4 (p = 0.007) and G5 (p = 0.001). Conclusion: Photosensitizers promoted E. faecalis reduction, with better results for tannin and curcumin. Alternative photosensitizers should be the focus of further studies.>< 0.001) and final collections (p < 0.001) for G2 and G3. In within-group comparisons, the number of CFUs showed a decreasing trend in G4 (p = 0.007) and G5 (p = 0.001). Conclusion: Photosensitizers promoted E. faecalis reduction, with better results for tannin and curcumin. Alternative photosensitizers should be the focus of further studies>< 0.001) for G2 and G3. In within-group comparisons, the number of CFUs showed a decreasing trend in G4 (p = 0.007) and G5 (p = 0.001). Conclusion: Photosensitizers promoted E. faecalis reduction, with better results for tannin and curcumin. Alternative photosensitizers should be the focus of further studies

Eccentric movements of temporomandibular joint and upper airway volume: Three-dimensional segmentation using cone beam computed tomography.

Objective: The purpose of the present investigation was to assess whether possible changes in the dynamic movements of the TMJ might cause a greater variation between the volumes of the upper airways in open- and closed-mouth positions.Methods: CBCT scans of 92 subjects were used to assess the TMJ bilaterally. All scans were acquired in closed (CM) and maximum mouth opening (MMO) positions. The difference in the volume of the oropharyngeal cavity obtained by subtracting the CM volume from the MMO volume (delta volume or volume variation) was calculated. The resulting volume was analyzed by Mann-Whitney test for variation in rotation.Results: A significant difference was found (p-value = 0.0188) on the right side regarding changes in the rotational movement of the condyle (Mann-Whitney test).Conclusion: This study showed a relationship between degree of abnormal or limited rotation and variation in the upper airway volume on one side.

Antimicrobial photodynamic therapy against Propionibacterium acnes biofilms using hypericin (Hypericum perforatum) photosensitizer: in vitro study.

Acne vulgaris is the most recurring skin condition in the world, causing great harm to the physical and psychological well-being of many patients. Antimicrobial photodynamic therapy (aPDT) has broad therapeutic applicability. The purpose was to evaluate in vitro the photodynamic inactivation against Propionibacterium acnes (P. acnes) biofilms by using different concentrations of hypericin (Hypericum perforatum) photosensitizer associated with different energies of low-level laser. The biofilms were placed in 96-well microplates with a 6.4-mm diameter surface, by using standard suspensions (2 × 107 CFU/mL) and grown in brain heart infusion broth (BHI) for 48 h in anaerobic chamber. Subsequently, the control group received application of 0.9% sterile saline solution for 3 min; the photosensitising groups received hypericin at concentrations of 5 and 15 µg/mL for 3 min; the laser groups received irradiation of energies of 3 and 5 J (660 nm, continuous output, 100 mW, 30 and 50 s and 100 J/cm2 and 166 J/cm2, respectively); the aPDT groups received 5 and 15 µg/mL concentrations of hypericin associated with energies of 3 and 5 J of low-level laser irradiation. After the biofilms were broken up and seeded for CFU counting. The results showed a reduction in P. acnes biofilms after aPDT emphasising that 15 µg/mL hypericin associated with 3 and 5 J laser irradiation reduced biofilms by 14.1 and 27.9%, respectively. In addition, all groups of aPDT demostrated statistically significant reductions. In vitro photodynamic inactivation against P. acnes biofilms using different concentration of hypericin photosensitizer associated with different energies of low-level laser promoted effective antimicrobial action.

The challenge of diagnosing atypical odontalgia. Case report / O desafio para o diagnóstico da odontalgia atípica. Relato de caso

ABSTRACT BACKGROUND AND OBJECTIVES: Atypical odontalgia is characterized by continuous pain that persists for more than three months in one or more teeth or in the socket after extraction, without apparent dental and neurological causes, with transient pain relief and worsening within a few days or even weeks in patients undergoing extensive dental treatment. These patients are at risk of going through unnecessary dental/surgical procedures, which would worsen their pain. This article aims to report a difficult case of atypical odontalgia diagnosis of a patient that underwent extensive dental treatment accompanied by severe pain. CASE REPORT: A 57-year-old female patient with severe and excruciating pain in the right maxillary region of no identified source. After an endodontic retreatment on teeth 14 and 16, the pain worsened suggesting traumatic pericementitis or reaction to the intracanal drug used. Since the pain did not improve, a pulpectomy on 13 was performed. However, the pain increased significantly, and after an evaluation by volumetric computed tomography, a paraendodontic surgery was performed, but the pain irradiated to the ocular fundus and the maxillary region. The absence of neurological, ophthalmological, and otorhinolaryngological alterations led to the diagnosis of atypical odontalgia. CONCLUSION: The diagnosis of atypical odontalgia is difficult, requiring a multidisciplinary approach listening to the patient's complaint, and, in case of doubt, avoid any procedures not to worsen pain and turn it chronic.

RESUMO JUSTIFICATIVA E OBJETIVOS: A odontalgia atípica caracteriza-se por dor contínua que persiste por mais de três meses em um ou mais dentes ou no alvéolo após extração, sem causas dentárias e neurológicas aparentes, com alívio transitório, e piora da dor dentro de poucos dias ou até semanas, em pacientes com amplo tratamento odontológico. A dificuldade para o diagnóstico pode levar a procedimentos odontológicos desnecessários e mutiladores, com piora e/ou cronificação da dor. Este artigo tem como objetivo relatar um caso de difícil diagnóstico de odontalgia atípica em paciente submetida a extenso tratamento odontológico. RELATO DO CASO: Paciente do sexo feminino, 57 anos, apresentava queixa de dor lancinante em região maxilar direita cuja origem não identificava. Após retratamento endodôntico dos dentes 14 e 16, houve piora da dor sugerindo pericementite traumática ou reação a fármaco intracanal. Como a dor não melhorou foi realizada uma pulpectomia no dente 13. Entretanto, a dor aumentou e após tomografia computadorizada volumétrica foi realizada cirurgia parendodôntica, porém a dor irradiou para fundo do olho direito e região maxilar. A ausência de alterações neurológicas, oftalmológicas e otorrinolaringológicas permitiram diagnosticar a odontalgia atípica. CONCLUSÃO: O diagnóstico é difícil, sendo recomendada a abordagem multidisciplinar, valorizar a queixa do paciente e, em casos de dúvida, evitar quaisquer procedimentos para não piorar e cronificar a dor.

Fracture resistance of metal-ceramic crown copings cemented to two types of intra-radicular posts / Resistência à fratura de copings de coroa metalocerâmica cimentados sobre dois tipos de retentores intrarradiculares

Introduction: Endodontically treated teeth are more susceptible to root fracture than vital teeth. In order to reduce the risk of fracture, the use of intra-radicular posts and crowns is indicated. However, their own fracture resistance remains unclear. Objective: To analyze the behavior of metal-ceramic crown copings cemented to two types of intra-radicular posts under tensile stress. Material and method: Sixteen metal-ceramic crown copings cemented with zinc phosphate cement to cast metal posts and cores (group 1, n = 8) or with self-adhesive resin cement to glass-fiber posts rebased with composite resin (group 2, n = 8) were subjected to tensile testing after endodontic treatment and standardized preparation. Failure occurred when the crown coping and/or post-core assembly fractured and/or detached. Result: In group 1, after the application of a mean tensile load of 46.83 N, 7 crown copings and metal cores separated as a whole, while in 1 specimen the coping detached from the metal core. In group 2, a mean tensile load of 127.68 N resulted in glass-fiber post fracture, and in 1 case the entire crown-post-core assembly was detached. Tensile strength differed significantly between the two groups (p = 0.0085). Conclusion: Our findings suggest that metal-ceramic crown copings cemented with self-adhesive resin cement show strong adhesion to composite resin cores associated with glass-fiber posts, thus providing a safe alternative to the use of cast metal posts and cores.

Introdução: Os dentes tratados endodonticamente são mais suscetíveis à fratura radicular do que os dentes vitais. Para reduzir o risco de fratura, indica-se o uso de coroas e retentores intrarradiculares. No entanto, ainda não está clara a resistência dessas estruturas a fraturas. Objetivo: Analisar o comportamento de copings de coroa metalocerâmica cimentados com dois tipos de retentores intrarradiculares sob tensão de tração. Material e método: Dezesseis copings de coroa metalocerâmica cimentados com cimento de fosfato de zinco para núcleos e pinos de metal fundido (grupo 1, n= 8) ou com cimento resinoso autoadesivo para núcleos de resina composta com pinos de fibra de vidro (grupo 2, n= 8) foram submetidos a testes de tração após tratamento endodôntico e preparo padronizado. Houve falha quando o coping da coroa e/ou a estrutura pino-núcleo se quebrou e/ou se soltou. Resultado: No grupo 1, após a aplicação de uma carga de tração média de 46,83 N, 7 copings e núcleos metálicos se separaram completamente, enquanto em 1 espécime o coping se soltou do núcleo metálico. No grupo 2, uma carga de tração média de 127,68 N resultou em fratura do pino de fibra de vidro, e em 1 caso toda a estrutura coroa-pino-núcleo se soltou. A resistência à tração foi significativamente diferente entre os dois grupos ( P= 0,0085). Conclusão: Nossos achados sugerem que copings de coroa metalocerâmica cimentados com cimento resinoso autoadesivo apresentam forte adesão aos núcleos de resina composta associados aos pinos de fibra de vidro, proporcionando uma alternativa segura ao uso de retentores de metal fundido.

Conhecimento de alunos e professores sobre medidas ergonômicas / Students' and teachers' knowledge of ergonomic measurements

Objetivo: Esta pesquisa teve como objetivo investigar o conhecimento e a utilização de conceitos ergonômicos aplicados à Odontologia por discentes e docentes nas clínicas-escola de uma faculdade de Odontologia. Métodos: Esse estudo investigou o universo de discentes matriculados em disciplinas clínicas (n=70) e respectivos docentes (n=23) do curso de Odontologia a respeito dos princípios ergonômicos utilizados na rotina clínica. Paralelamente foi pesquisada a incidência de sintomatologia dolorosa nos discentes por intermédio do questionário nórdico, The Nordic Musculoskeletal Questionnaire (NMQ), que é um instrumento de diagnóstico. A análise dos dados foi através do programa Statistical Package for the Social Sciences, realizada analítica e descritivamente. E a análise de associação entre as variáveis (Person). Resultados: Com relação à sintomatologia dolorosa, os maiores percentuais de acometimento foram nas regiões da parte superior das costas com 23,5%, 7 dias precedentes a entrevista e pescoço com 22,6%, 12 meses precedentes a entrevista. A maioria dos docentes entrevistados (65,2%) respondeu satisfatoriamente ao conceito de ergonomia de acordo com a Associação Internacional de Ergonomia. Com relação às medidas preventivas utilizadas na disciplina, 56,5% responderam que não utilizam medidas preventivas com relação às doenças ocupacionais. Conclusão: Pode-se concluir que o conceito de ergonomia entre os discentes participantes não foi completo e o mesmo conceito de ergonomia na percepção dos docentes, na maioria foi respondido de forma satisfatória.

Objective: This research aimed to investigate the knowledge and use of ergonomic concepts applied to Odontology for students and teachers in university clinics from a Dental School. Methods: This study investigates the realm of students registered in clinical disciplines (n=70) and the respective teachers (n=23) from the Dentistry course regarding ergonomic principles used in clinical routines. The incidence of painful symptomatology in the students was also researched by applying The Nordic Musculoskeletal Questionnaire (NMQ), which is a diagnostic tool. Data analyses were performed, both analytically and descriptively, using the Statistical Package for the Social Sciences and the analyses of association between the variables (Person). Results: Regarding painful symptomatology, the highest percentage of involvement were found in the regions of the upper back (23.5%), seven days before the interview, and in the neck (22.6%), two months before the interview. Most of the interviewed teachers (65.2%) responded satisfactorily to the concept to ergonomics according to the International Association of Ergonomics. As regards the preventive measures used in this discipline, 56.5% answered that they do not use preventive measures regarding occupational diseases. Conclusion: It can be concluded that the concept of ergonomics among the participating students was incomplete, and the same concept of ergonomics, from in the teacher's point of view, were mostly answered satisfactorily.

Assessing different patterns of laser welding with NickelChromium (Ni-Cr) alloy for structures applicable to fixed prosthesis / Avaliação de diferentes parâmetros de soldagem a laser em liga de Níquel-Cromo levando em consideração estruturas aplicáveis à Prótese Fixa

Objectives: Among all desired requirements to dental prosthesis, marginal adaptation and passive fit are the most important. In some cases, in order to achieve these goals, it is necessary to cut and weld the teeth / implant-supported framework. Nowadays, the laser welding process shows a great advantage in comparison to other methods. The aim of this study was to evaluate the optimal laser welds point that is more appropriate to Ni-Cr prosthetic framework. Material and methods: A total of 60 specimens of Ni-Cr (35 mm x 4 mm) were designed and welded using a Nd:YAG laser device model EV 900. They were fixed in a metal piece 0.27 mm between the ends to be welded. All specimens were welded with 21 laser pulses diametrically opposed (frequency of 1.0Hz, load time 3.0 ms and 0.5 mm of diameter pulse). They were divided into three groups according to the electric current of the laser weld: A ­ 180A; B ­ 200A; C ­ 220A; and D- control group with no welding process. To determinate the flexural mechanic strength, all specimens were submitted to a three-point bending test. Results: The results obtained were: Group A = 553,76 Mpa; B = 751,02 Mpa and C = 802.13 Mpa. The control group was 1040.9 Mpa. ANOVA and Tukey's test were performed and statistical significance differences were observed between group A and B as well as between group A and C. However, no significant difference was observed between B and C. The group D (no welding process), significant difference was observed between A, B and C. Conclusion: According to the methodology used, the groups B and C, among the welded groups, produced higher values of mechanical strength than the group A. The groups B and C were similar.(AU)

Objetivos: Entre os requisitos de uma prótese fixa estão a adaptação marginal e seu assentamento passivo. Em alguns casos, para alcançarmos estes requisitos, devemos realizar o seccionamento e soldagem da infraestrutura metálica. Os procedimentos de soldagem a laser apresentam várias vantagens em relação aos outros processos de união. O objetivo deste trabalho foi avaliar os parâmetros ideais para soldagens a laser em de infraestruturas protéticas em Ni-Cr. Material e métodos: Foram confeccionados 60 infraestruturas (35 mm X 4,0 mm), que foram soldadas utilizando um aparelho de solda a laser Nd:YAG modelo EV 900. As amostras foram fixadas em uma peça metálica, mantendo padronizada uma distância de 0,27 mm entre as extremidades a serem unidas. Todas as amostras foram soldadas com 21 pulsos diametralmente opostos (frequência de 1,0 Hz, tempo de carga de 3,0 ms e 0,5 mm de diâmetro do pulso) e foram divididas em três grupos experimentais, alterando-se a intensidade da corrente elétrica da solda a laser: A) 180 A; B) 200 A; C) 220 A e D) grupo controle -sem processo de soldagem. Para se determinar a resistência mecânica flexural, todas as amostras foram submetidas ao teste de flexão de três pontos em máquina de teste universal. Resultados: Os resultados médios obtidos foram: grupo A) 553 Mpa, B) 751,0 Mpa, C) 802,1 Mpa e para a amostra controle foi de 1040,9 Mpa. Foram realizados o teste estatístico paramétrico ANOVA e o teste de Tukey, e foi observado diferença estatisticamente significante entre os grupos A x B e grupos A x C. No entanto, não foi observado diferença significante entre os grupos B x C. No Grupo D (sem processo de soldagem) foi observado diferença significante quando comparado com os grupos A, B e C. Conclusão: De acordo com a metodologia utilizada o grupo C produziu os maiores valores de resistência flexural, seguidos pelos grupos B e A respetivamente.(AU)

Conhecimento dos profissionais da estratégia de saúde da família sobre diabetes e doença periodontal / The knowledge of family health program professionals on diabetes and periodontal disease

Este estudo tratou de uma abordagem de cunho quantitativo, que teve como objetivo avaliar parte do conhecimento dos profi s- sionais médicos, cirurgiões-dentistas e enfermeiros atuantes no programa de estratégia de saúde da família das cidades de Patos, Santa Luzia e São Mamede, no estado da Paraíba, sobre a relação bidirecional entre as duas doenças. Para a coleta dos dados, utilizou-se um formulário contendo questões relativas a dados sociodemográficos, diabetes e doença periodontal. Um total de 138 profissionais foi convidado a participar da pesquisa, sendo que 110 preencheram o termo de consentimento livre e esclarecido. Dos profissionais envolvidos neste estudo, 92,7% (n=101) informaram possuir conhecimento sobre doença periodontal; um total de 62,6% (n=67) da amostra afi rmou que o tratamento periodontal auxilia no controle glicêmico em pacientes diabéticos. Entre os participantes, 98,2% (n=108) afirmaram questionar fatores relacionados a diabetes durante a anamnese. A realização de um trabalho conjunto e multidisciplinar entre diferentes classes profissionais da saúde irá proporcionar uma melhor identificação e tratamento de pacientes com diabetes, predispostos ao desenvolvimento de doença periodontal.

This study consisted of a quantitative nature approach, which aimed to assess part of the knowledge of the medical professionals, dental surgeons and nurses who work in family health strategy program from the cities of Patos, Santa Luzia and São Mamede in the state of Paraiba, on the bidirectional relationship between the two diseases. For the data collection a questionnaire containing questions regarding socio- demographic data, diabetes and periodontal diease was applied to participants. A total of 138 professionals were invited to participate, with 110 filling in the informed consent form. From the professionals involved in this study, 92.7% (n=101) reported having knowledge about periodontal disease, a total of 62.6% (n=67) of the sample reported that periodontal treatment helps in glycemic control in diabetic patients. Among the participants, 98. 2% (n=108) reported questioning factors related to diabetes during anamnesis. The conducting of a collaborative and multidisciplinary work among different health professionals classes will provide better identification and treatment of diabetic patients predisposed to the development of periodontal disease.

Perfil dos estudantes de graduação em Odontologia: motivações e expectativas da profissão / Profile of undergraduate students in Dentistry: professional motivations and expectations

O objetivo deste estudo foi registrar o perfil dos estudantes de graduação em Odontologia quanto às motivações e expectativas. Foram analisados 98 alunos do curso de Odontologia das Faculdades Integradas de Patos, que preencheram um questionário com perguntas objetivas e subjetivas. Os resultados revelam que 68,4% eram do sexo feminino e a maioria do Estado da Paraíba (67,3%). Cerca de 80% fizeram vestibular em outra instituição e 40,8% fizeram de dois a três processos seletivos. A renda familiar predominante foi de 3 a 6 salários mínimos (40,8%). A expectativa dos participantes foi de formação profissional voltada para o trabalho (70,4%), o motivo de escolha principal foi a realização pessoal e profissional (69,4%), sendo a Odontologia uma dentre outras carreiras que poderia satisfazê-los (67,3%). Os resultados revelam que boa parte dos entrevistados estão motivados na área profissional e pessoal e suas expectativas são as melhores voltadas para a formação acadêmica e o trabalho. Há predominância de mulheres, a maioria dos estudantes acredita que o mercado de trabalho está saturado, mas almeja trabalhar seja em consultório individual, particular, público ou convênios. A vocação foi a maior explicação para a procura do curso, e a necessidade de continuar estudando é preocupação constante (AU).

The purpose of this study was to register the profile of Dentistry undergraduate students regarding motivations and expectations. Participated in this research, 98 students of the Undergraduate Course in Dentistry at Faculdades Integradas de Patos, who fill out a questionnaire with objective and subjective questions. The results show that 68.4% were female, most from the state of Paraíba (67.3%). Thereabouts 80% did entrance exams at another institution and 40.8% made two to three selective processes. The family income was predominant 3 to 6 minimum wages (40.8%). The expectation of participants was training geared to work (70.4%), the main reason for choosing was personal and professional achievement (69.4%) and dentistry was one among other careers that could satisfy them (67.3%). The results reveal that a good part of the interviewees are motivated in the professional and personal area and their expectations are the best geared towards the academic formation and the work. There is a predominance of women, most students believe that the job market is saturated, but they aim to work in individual, private, public or covenants. The vocation was the greatest explanation for the demand of the course, and the need to continue studying is a constant concern (AU).

Photoinactivation of Candida albicans using methylene blue as photosensitizer / Fotoinativação de Candida albicans utilizando azul de metileno como fotossensibilizador

Objective: To evaluate the effect of photodynamic therapy in the inactivation of Candida albicans planktonic cells, using methylene blue, 150 mg/mL, as a photosensitizer. Methods: Aliquots of 100 (μg/mL of the fungal suspension in a 106 cells/mL concentration were seeded in microtiter plates with 96 wells, where the same volume of methylene blue was deposited, remaining for 5 min pre-irradiation. Then, the low power laser light was applied (wavelength: 660 nm, power: 100 mW and dose: 426 J/cm2) for 128s using a portable semiconductor laser. Control experiments were performed without illumination and in the absence of methylene blue, and another in the presence of methylene blue without illumination and with illumination, replacing the photosensitizer by saline. In each experimental condition, serial dilutions (10-1 to 10-3) were obtained and 25 μL aliquots were seeded in Sabouraud Dextrose Agar duplicate. After this period, the number of colony forming units per milliliter (CFU/mL) was determined and the data were submitted to variance analysis and Kruskal Wallis test (p <0.05). Results: At the concentration of 150 μg/mL, and time of 5 min incubation, the reduction was significant (p˂0.05). In the absence of irradiation, methylene blue produced no reduction in CFU/mL. Conclusion: Photodynamic Therapy presented antifungal effect against Candida albicans and can be used as an adjunct to conventional treatment.

Objetivo: Avaliar o efeito da terapia fotodinâmica na inativação de células planctônicas de Candida albicans, empregando azul de metileno a 150 µg/mL como fotossensibilizador. Métodos: Alíquotas de 100 µg/mL da suspensão do fungo na concentração de 106 células/mL foram semeadas em placas de microtitulação com 96 poços, onde foi depositado o mesmo volume de azul de metileno, permanecendo por um período de pré-irradiação de 5 min. Em seguida, aplicou-se luz laser de baixa potência (comprimento de onda: 660 nm, potência: 100 mW e dose: 426 J/cm2) por 128s, utilizando um Laser semicondutor portátil. Experimentos controles foram realizados, sem iluminação e na ausência de azul de metileno, outro na presença de azul de metileno sem iluminação e com iluminação, substituindo o fotossensibilizador por solução salina. De cada condição experimental, diluições em série (10-1 a 10-3) foram obtidas e alíquotas de 25 μL foram plaqueadas em duplicata em Agar Sabouraud Dextrose. Após este período, o número de unidades formadoras de colônias por mililitro (CFU/mL) foi determinado e os dados foram submetidos à análise de variância e teste de Kruskal Wallis (p <0,05). Resultados: Na concentração de 150 μg/mL e tempo de 5 min de incubação, a redução foi significativa (p<0,05). Na ausência de irradiação, o azul de metileno não produziu redução de CFU/mL. Conclusão: A Terapia Fotodinâmica apresentou efeito antifúngico contra Candida albicans, podendo ser utilizada como coadjuvante ao tratamento convencional.

Penetration of a resin-based filling material into lateral root canals and quality of obturation by different techniques.

The aim of this study was to evaluate the penetration of a resin/polyester polymer-based material (Resilon Real Seal; SybronEndo Corp., Orange, USA) into simulated lateral canals, and the quality of obturations by different techniques. A total of 30 standardized simulated canals were divided into three groups according to the technique of obturation used: MS (McSpadden), SB (SystemB/Obtura II), and LC (Lateral Condensation). To analyze the penetration of the filling material, the simulated canals were digitalized and the images were analyzed using the Leica QWIN Pro v2.3 software. The data of the middle and apical thirds were separately submitted to analysis of variance (ANOVA), followed by the Tukey's test for the comparison of the techniques. Results showed a significant difference (p < 0.05) between groups (LC < SB) in the middle third, and a significant difference (p < 0.05) between groups (LC < SB and MS < SB) in the apical third. To analyze the quality of the obturations, the canals were radiographed and evaluated by three examiners. The Kappa test on interexaminer agreement and the nonparametric Kruskal-Wallis test indicated no significant difference between filling techniques. It was concluded that Resilon achieves greater levels of penetration when associated with thermoplastic obturation techniques.

Penetration of a resin-based filling material into lateral root canals and quality of obturation by different techniques

The aim of this study was to evaluate the penetration of a resin/polyester polymer-based material (Resilon Real Seal; SybronEndo Corp., Orange, USA) into simulated lateral canals, and the quality of obturations by different techniques. A total of 30 standardized simulated canals were divided into three groups according to the technique of obturation used: MS (McSpadden), SB (SystemB/Obtura II), and LC (Lateral Condensation). To analyze the penetration of the filling material, the simulated canals were digitalized and the images were analyzed using the Leica QWIN Pro v2.3 software. The data of the middle and apical thirds were separately submitted to analysis of variance (ANOVA), followed by the Tukey’s test for the comparison of the techniques. Results showed a significant difference (p < 0.05) between groups (LC < SB) in the middle third, and a significant difference (p < 0.05) between groups (LC < SB and MS < SB) in the apical third. To analyze the quality of the obturations, the canals were radiographed and evaluated by three examiners. The Kappa test on interexaminer agreement and the nonparametric Kruskal-Wallis test indicated no significant difference between filling techniques. It was concluded that Resilon achieves greater levels of penetration when associated with thermoplastic obturation techniques.

Perfil e percepção de diabéticos sobre a relação entre diabetes e doença periodontal / Profile and perceptions of diabetic about the relationship between diabetes and periodontal disease

Introdução: A periodontite é considerada um dos principais problemas de saúde em pacientes com diabetes e sua presença pode induzir resistência à insulina. Objetivo: avaliar o perfil e a percepção de pacientes com diabetes sobre a relação bidirecional entre diabetes e doença periodontal, assim como a integralidade da atenção primária à saúde destes pacientes. Método: Foi realizado um estudo epidemiológico de corte transversal, com 154 usuários cadastrados no programa HIPERDIA, em Unidades de Saúde da Família (USF), utilizando-se um questionário estruturado. Os dados foram registrados no SPSS e analisados por meio de estatística descritiva e inferencial, considerando-se um nível de significância de 5%. Resultado: A maioria dos pacientes pertencia ao gênero feminino (71,1%), apresentava baixa renda (73,2%) e escolaridade (42,5%), era não fumante (87,6%), com mais de 12 dentes perdidos (73,2%), escovavam os dentes duas vezes por dia (54,9%) e não utilizavam o fio dental (79,1%). Verificou-se associação estatisticamente significativa entre: gênero e número de escovações (p<0,001). Conclusão: Os pacientes com diabetes apresentam elevada prevalência de dentes perdidos, carência de informações sobre os cuidados de higiene bucal e acerca da relação entre a doença periodontal e diabetes, o que evidencia a necessidade uma maior integração entre o Cirurgião-Dentista e a equipe médica. .

Introduction: Periodontitis is considered one of the major health problems in patients with diabetes, and its presence may induce insulin resistance. Objective: To evaluate the profile and perception of patients with diabetes about the bidirectional relationship between diabetes and periodontal disease, as well as to evaluate the comprehensiveness of the primary health care toward these patients. Method: This was a cross-sectional epidemiological study applying a structured questionnaire to 154 users registered in the HIPERDIA program in Family Health Units (FHU). The data were recorded in SPSS and analyzed using descriptive and inferential statistics, with a significance level of 5%. RESULT: Most patients were females (71.1%), had low income (73.2%) and poor education (42.5%), were non smokers (87.6%), had more than 12 missing teeth (73.2%), brushed their teeth twice daily (54.9%) and did not use dental floss (79.1%). A statistically significant association was found between gender and number of brushings (p<0.001). Conclusion: Patients with diabetes have a high prevalence of missing teeth, lack of information about oral hygiene care and relationship between periodontal disease and diabetes, which highlights the need for greater integration between the dentist and the medical staff. .

Cement-retained prostheses increase risk of peri-implantitis when compared to screw-retained prostheses

Peri-implantitis is a dental plaque-associated inflammatory process characterized by bone crest resorption and the formation of peri-implant pockets. Plaque accumulation around implants is influenced by the quality of adaptation between the implant and its prosthetic components, which, in turn, may be dependent on the type of prosthetic system used. The aim of this study was to investigate whether cement-retained implant prostheses are greater risk factors for peri-implantitis than screw-retained prostheses, due to cementation line, which is located in the subgingival portion, serving as a local secondary etiological factor. 107 implants of 25 patients (with 32 cement-retained and 75 screw-retained prostheses) in function for a minimum of 6 months were evaluated based on peri-implant probing depth, bleeding on probing and radiographic bone loss. Overall, peri-implantitis was diagnosed around 63 implants (58.88%) of which 81.2% with cement-retained prostheses and 49.3% with screw-retained prostheses. Chi-Square analysis revealed a significant ass ociation between the use of cement-retained prostheses and the presence of peri- implantitis (p=0.004). Moreover, radiographic bone loss was greater around implants with cement-retained prostheses than in those with screw-retained configurations (2.39 and 1.84mm respectively, p= 0.001, Student t test). These results suggest that cement-retained prostheses increase both radiographically detectable bone loss around implants and the risk of peri-implantitis.

Gengiva artificial com restauração da papila em próteses unitárias sobre implantes mal posicionados: uma alternativa estética e de fácil higienização / Artificial gingiva with papilla restoration in sigle prostheses over malpositioned implants: An aesthetic and easy to clean alternative

A reabilitação bucal com implantes tem se tornado uma ótima opção de tratamento; no entanto, implantes mal posicionados muitas vezes apresentam dificuldade em uma resolução estética favorável. O presente trabalho teve como objetivo relatar uma abordagem alternativa para uma condição clínica de posicionamento desfavorável de implantes, com um planejamento protético inicial também desfavorável. Por meio de uma caso clínico foi apresentada uma alternativa viável para essas situações, de coroas individuais sobre implante com gengiva artificial, trazendo de volta a região das papilas, demonstrando ser essa uma alternativa eficiente no que diz respeito à estética e de fácil higienização — fator importante na manutenção da saúde peri-implantar

Oral rehabilitation with implants has become a great treatment option, however, poorly positioned implants often present dificulty in a esthetically favorable resolution. This study aimed to describe an alternative approach to clinical conditions with unfavorable positioning of implants and also unfavorable initial prosthetic planning. By means of a clinical case report it was presented a viable alternative for these situations, using individual crowns over implant with artificial gingiva, giving back the poper papillae region, proving to be an effective alternative with aesthetic benefits and easy cleaning, an important factor in maintaining peri-implant health

Analysis of apical sealing of canals irradiated with Er: YAG and Nd: YAG lasers and filled with AH Plus®

Introduction: Laser technology is gaining increasing importance in dental practice and also in the field of Endodontics with its ability to promote disinfection and experimentally in the preparation of root canal. The action of different types of lasers results in changes representing the increase in permeability of dentinal tissue (Er: YAG) or sometimes by a decrease in melting and recrystallization of dentin (Nd: YAG). Objective: this study assessed through apical dye leakage, the influence of irradiation with two types of laser, regarding to the quality of apical sealing of endodontic fillings. Material and methods: Thirty-six single-rooted teeth were used after being prepared with the ProFile system up to size #40 instrument and then divided into four experimental and two control groups. The technique used previously to the filling was as follows: G1 - not irradiated; G2 - irradiated with Er: YAG; G3 - irradiated with Nd: YAG and G4 - irradiated with Er: YAG followed by Nd: YAG. After external waterproofing and dry, the specimens were filled with a cold vertical condensation technique, using AH Plus sealer, and immediately immersed into 0.5% methylene blue solution for subsequent cleavage. The linear values of apical marginal leakage were obtained with the aid of an optical microscope connected to a computer using the Image Lab® software. Results: Data analysis showed the non-existence of statistically significant (p = 0.05) differences between different groups. Conclusion: It was concluded that the laser does not have influence on the apical sealing.

Effect of chemical and Er:YAG laser treatment on bond strength of root canal resin-based sealers.

Different treatments of dentin walls, as laser irradiation, prior to obturation can influence the adhesion ability of endodontic sealers. Therefore, the objective of this study was to compare in vitro the shear bond strength of four resin-based sealers to dentin treated with citric acid solution or erbium: yttrium, aluminum, garnet (Er:YAG) irradiation. A total of 240 slices with 1.6 mm of thickness were cut using middle third of 84 teeth. Each slice was widened using a #45 taper.06 rotary K3 instrument. The sample was divided into groups according to dentin pretreatment (15 % citric acid or Er:YAG laser) and sealer used (AH Plus, Acroseal, EndoREZ, or RealSeal). Shear bond strength was measured using a universal materials testing machine. As results, significant differences were found when comparing sealers between all groups (p < 0.05) by Kruskal-Wallis test, regardless of the pretreatment used. Comparing pretreatments, 15 % citric acid solution had better outcomes than Er:YAG laser, with significant differences in all groups, except for Acroseal groups (p < 0.05). It was concluded that RealSeal and 15 % citric acid solution achieved the best results regarding the sealer and pretreatment used, respectively.

Qualitative analysis of files of four different rotary systems, before and after being used for the twelfth time.

The aim of this study was to make a comparative evaluation of the surface topography of the cervical third and tip of four different rotary systems, before and after being used 12 times, in resin blocks with simulated root canals with standardized 45° curvatures, and analyzed by scanning electronic microscopy (SEM). A total of 1,440 resin blocks with simulated root canals and standardized curvatures were used. The blocks were divided into four groups and prepared by the crown down technique according to the manufacturers' recommendations: Group 1 (G1)--K3®, Group 2 (G2)--Protaper Universal®, Group 3 (G3)--Twisted Files®, and Group 4 (G4)--Biorace®. After each preparation, the instruments were washed and autoclaved. A total of 24 instruments were selected, being three new instruments and three after having been used for the 12th time, from each group. These instruments were analyzed by SEM. To perform the evaluation, 24 micrographs were observed by 12 evaluators who attributed a score to the images according to a template. In the qualitative analysis of the cervical region and tip of new instruments, it was observe that the files of Groups G4 and G2 were the least rough and those of G1, the roughest. In the same manner, the cervical region of the instruments was qualitatively analyzed after the 12th time of using them, and there was no statistically significant difference at a level of 1% (ANOVA P < 0.01) between G2 and G4 as well as between G1 and G3. As regards the tip, it was observed that there was no statistically significant difference, at a level of 1%, between the groups: G1 and G3, G1 and G4, and between G3 and G4, and there was statistically significant difference at a level of 1%, between group G2 and the other groups, with G3 having the greatest roughness (ANOVA P < 0.01).

Condição odontológica em pacientes internados em unidade de terapia intensiva / Oral conditions of patients admitted to an intensive care unit

Objetivo: Avaliar clinicamente a condição odontológica de pacientes internados em Unidade de Terapia Intensiva (UTI). Método: Foi realizado estudo exploratório, descritivo e transversal com avaliação clínica odontológica de 50 pacientes internados em UTI do Hospital São Vicente de Paula (João Pessoa/PB). Foram coletados os dados dos prontuários médicos relativos à idade, sexo, fator causal da internação e comorbidades relacionadas a problemas pulmonares. A análise da condição bucal foi qualificada em três categorias: boa (condição aceitável de higiene sem sangramento ao toque ou focos de infecção aparentes); regular (paciente apresentava pouco sangramento ao toque e/ou candidíase observada clinicamente como placas esbranquiçadas sobre mucosa inalterada ou avermelhada, removidas mecanicamente); e ruim (presença de abscessos e candidíase disseminada incluindo orofaringe). Resultados: A idade média dos examinados era de 53,8 (±18,5) sendo 23 (46%) do sexo masculino. As causas das internações de 24 (48,0%) pacientes foram neurológicas e de 26 (52%) por problemas renais, cardíacos, metabólicos, respiratórios e septicemia. Foram registrados quadros de pneumonia em 56% dos pacientes. Quanto à distribuição das condições de saúde bucal, observaram-se porcentagens significativamente maiores (p menor que 0,001) da condição de higiene ruim, comparadas às outras condições.Conclusões: A maioria dos pacientes internados em Unidade de Terapia Intensiva apresentava condição odontológica ruim, e a candidíase foi a infecção mais prevalente.

Objective: To evaluate clinically the oral conditions of the patients admitted to an Intensive Care Unit (ICU). Method: An exploratory, descriptive and transversal study was developed with clinical oral evaluation of 50 patients admitted to the ICU of the São Vicente de Paula Hospital (João Pessoa, PB, Brazil). The data were collected from the medical files concerning age, gender, cause of admission and comorbidities relative to lung problems. The oral condition was classified into three categories: good (acceptable hygiene, no gingival bleeding to touch or visible infection foci); regular (little gingival bleeding to touch and/or clinically visible candidiasis as white plaques on healthy or reddish mucosa, removed mechanically) and poor (presence of abscesses and widespread candidiasis, including the oropharynx). Results: The mean age of the patients was 53.8 (±18.5) years, 23 (46%) of them being male. Twenty-four (48%) patients were hospitalized due to neurological causes and 26 (52%) due to kidney, cardiac, metabolic or respiratory problems and septicemia. Pneumonia was present in 56% of the patients. As for the oral health conditions, there were significantly higher percentages (p less than 0.001) of poor conditions compared with the other conditions. Conclusion: Most patients admitted to the ICU presented poor oral condition and candidiasis was the prevalent infection.